The need to tailor the omission of axillary lymph node dissection to patients with good prognosis and sentinel node micro‐metastases

Abstract

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Axillary management in patients with clinical node-negative early breast cancer and positive sentinel lymph node: a systematic review and meta-analysis

“…Twenty-two studies reported overall survival data ( 5 , 7 , 11 , 15 – 27 , 29 , 30 , 32 , 33 , 35 ). Eleven studies reported disease-free survival data ( 5 , 7 , 11 , 15 , 23 , 30 – 35 ). Six studies analyzed locoregional recurrence ( 21 , 26 , 28 , 35 , 36 ), and eight studies reported axillary recurrence ( 11 , 22 , 24 , 26 , 30 , 32 , 33 , 35 ).…”

“…The NOS was used to assess the quality of evidence in non-RCT trials. Five studies received a rating of seven or more stars, indicating high quality ( 15 , 16 , 19 , 21 , 35 ).Seven studies received a rating of six stars ( 11 , 20 , 22 , 23 , 26 , 34 , 36 ), and six studies were assessed as having four to five stars (See Table 1 ). The GRADEpro GDT tool was used to classify the evidence of RCTs comparing ALND to SLNB alone for patients with clinical node-negative early-stage breast cancer and positive sentinel lymph nodes.…”

“…Table 1 outlines the characteristics of the included studies. Eighteen studies were retrospective cohort studies (11,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(34)(35)(36), while the remaining eight were RCTs (5,7,(28)(29)(30)(31)(32)(33). The studies were published between April 2009 to July 2023.Sample sizes range from 121 to 97,314 patients, with a total of 145,548 patients analyzed.…”